Although mainstream medicine has been coming around to the ills of trans fat since only the late 1990s, suspicions about it started bubbling up in the scientific community in the late 1970s, led by the nation's premier lipid researcher, Mary Enig. The biochemistry professor at the University of Maryland was the first researcher to make a compelling case that trans fatty acids were dangerously different than saturated animal fat, and that instead of being the solution to ridding the American diet of saturated fats, trans fat was doing more harm.

The problems with trans fat are many. Like beef fat, trans fat also raises the level of bad cholesterol (LDL), which can clog the arteries and make them inflexible, leading to strokes and heart attacks. But trans fat takes things one step further, scrubbing away the good cholesterol (HDL) that keeps arteries clean. Trans fat also raises other bad blood lipids that can contribute to heart disease. And it does its work faster. An American Heart Association study released in 2002 showed that food cooked with trans fat clogs arteries quicker than food cooked in animal-based saturated fat. But trans fat has what researchers are beginning to agree is a more insidious function in the body: It actually reprograms how cells work, causing lifelong damage that can lead to diabetes, stroke, and possibly cancer. Unlike saturated fats from animals, trans fats aren't easily broken down in the body. The molecular structure of trans fat is so different, so unnatural, that the body has no way to know exactly how to process it. That's why some doctors, in particular the top nutrition and heart experts at Harvard University, believe trans fat is worse than saturated fat.

BEYOND HEART DISEASE

A growing number of doctors also believe trans fat plays a starring role in a health crisis more prevalent and possibly more damaging than, clogged arteries: Syndrome X. Also called metabolic syndrome or, more commonly, beer belly syndrome, the condition has increased along with the amount of refined foods and partially hydrogenated oil Americans eat. Former Stanford University director of endocrinology Gerald Reaven named Syndrome X in 1988 after he observed a collection of health problems ultimately linked to cells' inability to process insulin. Researchers believe trans fat is one of the reasons cells malfunction. Although trans fat only makes up a small part of the average daily diet-somewhere between 3 to 8 percent of the total daily caloric intake-even a handful of grams a day is enough to gum up the workings of a cell. Dr. Jeffrey M. Aron, coauthor with Harriette E. Aron of Gut-Check: Your Prime Source for Bowel Health and Colon Cancer Prevention (1stBooks Library, 2001), explains it like this: Picture the cell as a Swiss watch. Sprinkle a few very fine grains of sand in that watch and it will continue to tick, but after a while it won't keep accurate time. Eventually it won't work. That's how trans fat works in the body, he says. It changes how the cell membranes work how they talk to each other and function. Trans fat can help make cells resistant to insulin, and when you have resistance to insulin you have obesity, he believes.

In 2002, researchers at the Centers for Disease Control (CPC) released estimates that showed at least 47 million Americans, more than 20 percent, could have Syndrome X. Other Syndrome X experts say that estimate is conservative and put the figure as high as 70 million. If you have a combination of any three of these symptoms-high blood sugar, high blood pressure, high levels of blood fats called triglycerides, high, cholesterol, or abdominal obesity-the beer belly-you probably have Syndrome X. People with Syndrome X are likely candidates for diabetes, heart, attack, cancer, and even Alzheimer's, says jack Challem, a Tucson-based nutrition expert who has written extensively on Syndrome X. Challem, coauthor with Burton Berkson of Syndrome X: The Complete Nutritional Program to Prevent and Reverse Insulin Resistance (John Wiley & Sons, 2001), says that trans fat is such a hidden part of the American diet, people have no idea what it contributes to their illness. "Forty years after it's been in the food system on such a large scale, what is becoming clear is that this is dangerous stuff," Challen said.

And like many health experts, he's amazed at how prevalent yet how hidden trans fat is. It truly is a stealth fat. "One of the defining moments for me came when I looked at a box of breakfast bars," says Challem. "Half the fat was saturated fat, but there was no animal product in the ingredient list," he says. "This is in everything. It's like a wild card. It's as if you're screwing up how the body processes food."

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